title: Avascular necrosis of femoral head as the initial manifestation of CML.
abstract: A 12-year-old female is reported who presented with right hip pain for 6 months. With massive splenohepatomegaly and leukocytosis, CML was suspected and confirmed on bone-marrow examination and cytogenetics. Further investigations confirmed avascular necrosis (AVN) of the right femoral head. CML was treated by hydroxyurea, followed by imatinib. AVN was managed conservatively; patient demonstrated progressive improvement, though a mild limp in the gait was persisting at 22 months. AVN as the initial manifestation of CML is a rarity. Leukostasis is considered to be the pathophysiological mechanism. In view of the rarity, a case is reported, along with compilation of previously reported cases.
authors.affiliation: Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Kumar
authors.forename: Deepak
authors.initials: D
authors.lastname: Bansal
authors.forename: Mahesh
authors.initials: M
authors.lastname: Prakash
authors.forename: Prashant
authors.initials: P
authors.lastname: Sharma
mesh_terms: D005260:Female; D005271:Femur Head Necrosis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000473:pathology*
keywords: MRI; acute lymphoblastic leukemia; bone scan; chronic myeloid leukemia; hyperviscosity; osteonecrosis